背外侧前额叶对主动遗忘负性社会反馈的作用:针对抑郁症的TMS研究  

The Role of Dorsolateral Prefrontal Cortex on Voluntary Forgetting of Negative Social Feedback in Depressed Patients:A TMS Study

作　　者：陈玉明[1] 李思瑾 郭田友[1,2] 谢慧 徐锋 张丹丹 Chen Yuming;Li Sijin;Guo Tianyou;Xie Hui;Xu Feng;Zhang Dandan

机构地区：[1]深圳大学心理学院,深圳518060 [2]华中科技大学协和深圳医院,深圳518052 [3]深圳英智科技有限公司,深圳518010 [4]深港脑科学创新研究院,深圳518055 [5]深圳大学磁共振成像中心,深圳518060

出　　处：《复印报刊资料（心理学）》2022年第2期3-15,共13页

基　　金：国家自然科学基金面上项目(31970980,31871115);广东省哲学社会科学规划(GD20CXL08);深港脑科学创新研究院(2021SHIBS0003);广东省科技厅国际科技合作领域项目(2019A050510048)支持。

摘　　要：抑郁症患者的负性心境可能源于其抑制功能障碍。患者在主动遗忘负性材料时无法有效调用背外侧前额叶(the dorsolateral prefrontal cortex,DLPFC)等负责抑制控制的额叶脑网络。同时,患者对社会信息的加工比对非社会信息的加工存在更明显的认知神经障碍,很难主动遗忘对自己不利的社会反馈信息。为了提高抑郁症患者对负性社会反馈的主动遗忘能力,本研究采用经颅磁刺激技术(transcranial magnetic stimulation,TMS),考察抑郁症患者在左侧(n=32)或右侧DLPFC(n=30)被激活后其记忆控制能力的改变。结果表明,当患者的DLPFC被TMS激活时,他们对社会拒绝的回忆正确率与健康对照组(n=31)无差异,且TMS激活右侧DLPFC还改善了患者对他人的社会态度。本研究是采用TMS提高抑郁症患者主动遗忘能力的首次尝试,研究结果不但支持了DLPFC与记忆控制功能的因果关系,还为临床治疗抑郁症、创伤后应激障碍、药物成瘾等患者的记忆控制缺陷提供了明确的神经靶点。Depression is a common mental disorder characterized by persistent low mood and anhedonia.While healthy people can voluntarily forget unpleasant events,depressed patients cannot or have difficulty in forgetting negative stimuli.Studies focused on healthy population have found that memory suppression is not only associated with decreased neural activation in the hippocampus,but also significantly activates a wide network in the prefrontal cortex,especially the right dorsolateral prefrontal cortex(DLPFC).Meanwhile,studies have demonstrated that de-pressed participants could not effectively recruit their frontal brain network responsible for inhibition control of nega-tive materials.Thus,the key question of this study is to examine whether an enhancement of the neural activation in DLPFC using transcranial magnetic stimulation(TMS)could improve the ability of voluntary forgetting of negative information in depressed patients.We recruited a total of 123 participants.Among them,31 healthy participants were stimulated by TMS at the right DLPFC(right DLPFC-activated controls),32 patients and 30 patients were stimulated by TMS at the left and right DLPFC respectively(left and right DLPFC-activated patients).The other 30 patients were assigned into a sham TMS group.This study contained three independent variables.The two within-subject variables were TMS(baseline or TMS condition)and directed forgetting instruction(remember or forget),and the between-subject variable was group(left or right DLPFC-activated patient,or right DLPFC-activated control).We focused on the memory suppression of social feedbacks in this study,since social feedback processing plays a vital role in everyday interpersonal activities.Previous studies have found that depressed patients cannot perceive and evaluate social feedbacks accurately and adaptively,which makes negative social experiences being an important inducing factor of depression.Meanwhile,evidence indicates that depressed patients have more deficits in processing social relative to nonso

关 键 词：抑郁症 经颅磁刺激 背外侧前额叶 主动遗忘 社会反馈 负性记忆 定向遗忘 

分 类 号：R749.4[医药卫生—神经病学与精神病学]